| NPI | 1316651383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS NISSIRIOS Medical Director 718-504-7378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-12-28 |